Viscera retainer for use in abdominal operations



Feb. 22

H. JCARBEGAST VISCERA RETAINER FOR USE I ABDOMINAL OPERATIONS 2Sheets-Sheet 1 Filed May i, "19

mifirh asi 55 u Feb. 22, 1927. 3,618,261

11. .1. ARBOGAST I Y VISCERA RETAINER FOR USE IN ABDOMINAL OPERATIONSFiled May 1, 1 92s 2 Sheets-Sheet 2 Peri Zaneum 71mm, MW? 5 6 .32 A; /07 33 that I-IOYE J. ARBOGAST, OF ROCK SPRINGS, WYOMING.

VISCERA RETAINER FOR USE IN ABDOMINAL OPERATIONS.

Application filed May 1,

This invention relates to surgical instru ments and particularly tomeans for retaining the abdominal viscera in place and from protrusionwhile effecting a closure of the peritoneum.

The general object of this invention is to provide an instrument forthis purpose which is so constructed that it may readily be introducedinto the wound or removed therefrom and in this connection to provide aninstrument formed in a plurality of longitudinally extending sectionswhich are operatively locked together while the peritoneum is beinginitially sewed up and and in which the sections may be withdrawn one byone as the sewing nears completion.

A further object is to provide a device of this character having a broadand flattened portion which when introduced in the wound inside of theparietal wall may be held against this wall with sufiicient firmness toprevent any of the viscera from projecting into the wound and,therefore, preventing the introduction of the suture which is to closethe peritoneum.

Other objects have to do with the details.

of construction and arrangement of parts to appear more fullyhereinafter.

My invention is illustrated in the accompanying drawings wherein Figure1 is an edge elevation of my 111- strument;

Fig. 2 is a top plan view with the several sections engaged with eachother and ready for introduction into the wound;

Fig. 3 is a fragmentary top plan view with the sections separated;

Fig. 4 is a bottom plan view like Figure 3 and showing the sectionsseparated;

Fig. 5 is a section on the line 55 of Figure 1;

Fig. 6 is a longitudinal fragmentary section through the handle of thedevice and showing the latching means;

Fig. 7 is a section on the line 77 of Figure 2; I

Fig. 8 is a section on the line 88 of Figure 3;

Fig. 9 is a perspective View of the instrument in actual use.

Referring to these drawings, and particularly to Figures 1 and 3, itwill be seen that the instrumentis formed of three separate sections, Abeing the middle section and B and C being the lateral sections. Themiddle section consists of the flat and rela- 192'6. Serial No. 105,033.

tively narrow blade 10. The rear portion' The rear end of the handle soformed is downwardly bent as at 13. The forward extremity of the blade10 is formed with two forwardly projecting relatively short pins 14disposed on each side of the medial line of the blade. The rear portionof the blade 10 is depressed as at 15, this depressed portion extendingdownward and rearward at a slight angle to, the face of the blade 10,there being convergent shoulders 16 which define the forward boundary ofthis depressed portion 15.

The section B consists of a flat blade 17 the same width at its middleas the blade 11 and adapted to be disposed in edge contact with the sameand with its upper face flush with the upper face of the blade 10. Theforward end of this blade 17 is beveled at its outer corner as at 18,and the forward extremity of the blade 17 is inwardly extended as at 19,this inward extension beingv formed with a recess 20 to receive one ofthe pins 1 The rear portion of theblade 14 is inwardly extended at 21 sothat the inner edge face of this angular portion 21 will bear againstthe corresponding shoulder 16. This blade 17 is also provided with theupwardly extending shanlr 22 corresponding to shank 11, which shankextends upwardly and rearwardly and extends rearwardly parallel to theface of the blade as at 23. The shank 22 and the handle portion 23 havea'width equal to half the width of the shank 11 and in use overlie thisshank.

The section C is constructed in the same manner as the section B and theseveral reference numerals have been used to designate like parts. Thesection C is complementary to the section B so that when the sections Band C are disposed in engagement with the section A, the blades 17 ofthe sections B and G will lie against and flush with the blade 10, asillustrated in Figure 2, and the portions 21 of the two lateral sectionswill fit against the shoulders 16 and the handle portions 23 will extendover and rest upon the handle portions 11 and 12.

Adjacent the rear ends of the portions 23 are apertures 2e and thehandle portion 12 of section A is provided with a pair of upwardlyprojecting studs 25. adapted to pass responding pin.

through these apertures 24;. Mounted upon the rear ends of the handlesections 23 are slidable latches 26, each of these latches beinglongitudinally slotted and guided by two screw pins 27 extending throughthe latches and into the corresponding handle sections. The forward endof each latch is beveled and each pin or stud 25 is notched to receivethe beveled end of the corresponding latch. A spring 28 is disposedwithin the slot 29 of the latch and urges the latch forward and intoengagement with the cor- 4 Preferably a washer-like plate 30 is disposedbetween the screw heads of the screws 27 and the face of each latch,thus holding the latch firmly in place but permitting its slidingmovement. Each latch at its rear end is angularly bent as at 31 toprovide a finger hold whereby the latch may be retracted. The under faceof the rear end of each blade portion 17 is recessed at 32 or depressed,this depressed or recessed portion 32 being complementary to one half ofthe recessed portion 15 on the section A so that the edgefaces of theportions 21 will abut against the shoulders 16 and the recessed portions32 will lie over the recessed portions 15 and thus the faces of allthree blade portions rearward to the handle'will be disposed in oneplane or flush with each other. I

It will be seen that with this construction the lateral sections 13 andC will be held in engagement with the middle section A so long'a's thelatches are projected into em gagement'with the studs 25 but that when alatch 26 is retracted, the corresponding section'may then be slightlylifted to withdraw the stud 25 from the aperture 24: and then slightlyshifted forward which will de- 'tach the portion 19 from its engagementwith the corresponding pin let and thus the several sections may bedetached from each other within a wound and withdrawn through theopening of the wound.

In the actual use of this device the three sections are engaged witheach other as shown in Figures 1, 2 and 9 an'dthe broad fiat portion ofthe instrument is introduced into the wound inside of the parietalperitoing slightly raised to detach it from engage ment withthe'corresponding pin 25, is

-pushed very slightly ahead so as to release it from its engagement withthe corresponding pin 14. Then this section is easily withdrawn sinceits width is no greater than the width of the neck of the instrument.The other section is then withdrawn in a similar manner and lastly themiddle section is withdrawn and then the last stitch or two which arenecessary to finish the closure are taken.

In the actual operation a small retractor is placed so as to retract themuscular fascia, next the apices of the wound are grasped by smallforceps and then the instrument is inserted. When this has been acco1n-'plished the operator is ready to commence stitching up the wound. itwill be seen that this device is very simple,- is very effective for thepurpose intended, that it is easily introduced and removed withoutinjury to the parts and that while it is particularly designed for thepurpose disclosed it is, not necessarily limited to this purpose as itmight be used in other operations.

It will be noted that. this instrumentnotonly holds the viscera fromprotruding into thewound but supports the peritoneum so that stitchesmay be more readily taken therethrough.

I claim r 1. A visceral retainer-consisting of a plu plane and thehandle portions of certain sections overlapping.

3. A visceral retainer consisting of amiddle section and two lateralsections, each section having a blade portion and a handle portion, thesections being detachably engaged with each other with the bladeportions lying in the same plane, each lateral section when detachedfrom the middle section being from a wound. I

4. A visceral retainer consisting of amiddle section and two lateralsections, each section having a blade portion and a handle portion, thesections being detachably engaged with each other with the bladeportions lying in the same plane, thelateral sect-ions being eachdetachable indepenldently from the middle section. a

5. A visceral retainerconsisting of amiddle section and two lateralsections, the middle section having a blade portion and a handle ortion,the two lateral sections coacting independently withdrawable with themiddle section, each lateral section V I middle section, the handleportion of the lateral sections being adapted to overlie the handleportion of the middle section, and means on each lateral section fordetachably locking it to the middle section.

6. A visceral retainer consisting of a middle section and two lateralsections, the middle section having a blade portion, an upwardly andrearwardly extending shank, and

i a longitudinally extending handle, the lateral sections each having ablade portion, an upwardly and rearwardly extending shank, and arearwardly extending handle, the shank and handle of each lateralsection having a width approximately half the width of the shank andhandle of the middle section, the upper face of the blade portion of themiddle section at the rear thereof being depressed, this depressionbeing defined by two rearwardly converging shoulders, the rear of eachlateral section being inwardly offset to provide an inner inclined; edgeadapted to bear against the corresponding shoulder of the middlesection, the under face of the laterally offset portion being reduced inthickness whereby to permit the laterally offset portions to fit overthe depression at the rear end of the middle section and permit thehandle portions of the lateral sections to overlie the handle portion ofthe middle section, and means for engaging the sections to each other.

7. A visceral retainer consisting of a middle section and two lateralsections, the middle section having a blade portion, an upwardly andrearwardly extending shank, and a longitudinally extending handle, thelateral sections each having a blade portion, an upwardly and rearwardlyextending shank and a rearwardly extending handle, the shank and handleof each lateral section having a width approximately half the width ofthe shank and handle of the middle section, the upper face of the bladeportion of the middle section at the rear thereof being depressed, thisdepression being defined by two rearwardly converging shoulders, therear of each lateral section being inwardly offset to provide an innerinclined edge adapted to bear against the corresponding shoulder of themiddle section, the under face of the laterally offset portion beingreduced in thickness whereby to permit the laterally ofi'set portions tofit over the depression at the rear end of the middle section and permitthe handle portions of the lateral sections to overlie the handleportion of the middle section, and means for engaging the sections toeach other comprising coacting pins and recesses formed respectivelyupon the forward ends of the lateral and middle sections and latchesdetachably engaging the handle of each lateral section with the handleof the middle section.

8. A visceral retainer consisting of a middle section and two lateralsections, the middle section having a blade portion, at upwardly andrearwardly extending shank, and a longitudinally extending handle, thelateral sections each having a blade portion, an upwardly and rearwardlyextending shank, and a rearwardly extending handle, the shank and handleof each lateral section having a width approximately half the width ofthe shank and handle of the middle section, the upper face of the bladeportion of the middle section at the rear thereof being depressed, thisdepression being defined by two rearwardly converging shoulders, therear of each lateral section being inwardly offset to provide an innerinclined edge adapted to bear against the corresponding shoulder of themiddle section, the up per face of the laterally offset portion beingreduced in thickness whereby to permit the laterallyoffset portions tofit over the depression at the rear end of the middle section and permitthe handle portions of the lateral sections to overlie the handleportion of the middle section, and means for engaging the sections toeach other comprising latches mounted upon the rear ends of the handleportions of the lateral sections, studs projecting from the middlesection, the handles of the lateral sections being perforated for thereception of said studs and the latches engaging said studs, the forwardends of the lateral sections being inwardly extended to'engage aroundthe forward end of the blade portion of the middle section, the middlesection being provided with outwardly projecting studs, and the curvedends of the lateral sections having recesses to receive said studs.

In testimony whereof I hereunto afi'ix my signature.

HOYE J. ARBOGAST.

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